Three Part Question

In [patients with life threatening haematuria] does [tranexamic acid] [improve outcomes]

Clinical Scenario

A 70yr old man is rushed into resus with a BP of 60/30. He has been passing blood and clots in the urine for the last 24 hours. As you commence fluid resuscitation you wonder whether tranexamic acid may have a role in his manageemnt

Comment(s)

The evidence for the use of tranexamic acid in life-threatening haematuria is weak and predominantly in patients with autosomal-dominant polycystic kidney disease. The case reports do suggest a benefit, but larger studies are needed to prove this benefit and exclude the increased risk of thromboembolic complications.

Clinical Bottom Line

The evidence is limited, but there may be a role for tranexamic acid in life-threatening haematuria, particularly in patients with autosomal-dominant polycystic kidney disease.